{
  "id": 3047007,
  "name": "Brand, Beck & Hoover, Associates, Claimant, v. The State of Illinois, Respondent",
  "name_abbreviation": "Brand, Beck & Hoover, Associates v. State",
  "decision_date": "1992-03-24",
  "docket_number": "No. 89-CC-2196",
  "first_page": "284",
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    "name_abbreviation": "Ill. Ct. Cl.",
    "id": 8793,
    "name": "Illinois Court of Claims"
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    "name_long": "Illinois",
    "name": "Ill."
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  "last_updated": "2023-07-14T20:39:29.978535+00:00",
  "provenance": {
    "date_added": "2019-08-29",
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  "casebody": {
    "judges": [],
    "parties": [
      "Brand, Beck & Hoover, Associates, Claimant, v. The State of Illinois, Respondent."
    ],
    "opinions": [
      {
        "text": "OPINION\nSommer, J.\nThis vendor-payment action identifies the Claimant as \u201cBrand, Beck & Hoover Assoc.,\u201d apparently a physician group practice, and the Illinois Department of Public Aid (IDPA) as the responding agency. The claim seeks payment for radiology services rendered to patient McCalla, an IDPA recipient, during the period May 12 through July 25, 1988. The Claimant\u2019s complaint, filed with this Court on January 19, 1989, lists the patient\u2019s name and IDPA-assigned recipient ID number (BIN); however, in the complaint there is no specific allegation or exhibit, capable of being investigated or verified, that Claimant\u2019s physician\u2019s charges for any of the subject services had been invoiced to IDPA for payment, though the bill of particulars states IDPA was \u201cbilled.\u201d\nRespondent has moved for summary judgment on this claim pursuant to section 2\u20141005 of Illinois\u2019 Code of Civil Procedure (Ill. Rev. Stat., ch. 110, par. 2\u20141005), raising the issues discussed herein.\nIn its motion, the Respondent contends: first, that the Claimant group practice is not an enrolleeparticipant in its Medical Assistance Program (MAP) and thus has no standing to bring this action (Ill. Rev. Stat., ch. 23, par. 11\u201413; Pinckneyville Medical Group v. State (1988), 41 Ill. Ct. Cl. 176); second, that the complaint\u2019s failure to identify the physician or physicians who performed the services prevents IDPA from investigating the claim; and third, there is no allegation here that a physician\u2019s charges for any of these services had been invoiced to the Department in the manner and within the time prescribed by IDPA Rule 140.20 (89 Ill. Adm. Code \u00a7140.20; and Topic 141 of IDPA\u2019s MAP vendor Handbooks). These are the same deficiencies which the Court found to require dismissal of a similar claim in University of Chicago Professional Services Offices v. State (1990), 42 Ill. Ct. Cl. 277.\nSections 439.8 (a) and (b) of the Court of Claims Act (Ill. Rev. Stat., ch. 37, pars. 439.8(a),(b)) and section 11\u201413 of the PAC offer vendor-claimants the opportunity to have this Court review and assess IDPA\u2019s prior \u201caction taken\u201d (section 790.50(a)(3) of the Court of Claims Regulations), in response to an administrative claim, or invoice, which the vendor has previously submitted and the Department has failed or refused \u201cto pay * * # in whole or in part\u201d (PAC \u00a711\u201413). The Court\u2019s function, in section 11\u201413 actions, is that of assessing the merits of the vendor\u2019s claim against the reasons offered by IDPA for its previous refusals to pay that claim. To invoke this Court\u2019s authority, a vendor-claimant must be able specifically to allege in its complaint, and to. prove, that its \u201cclaim (invoice, for specific goods or services) has been previously presented\u201d to IDPA (section 790.5(a) (3) of the Court of Claims Regulations) in accordance with IDPA Rule 140.20\u2019s requirements, because such prior administrative presentation of the claim to IDPA \u201cis an essential element of a section 11\u201413 * * * action.\u201d University of Chicago Professional Services Offices v. State, supra, at 283; see Simon v. State (1987), 40 Ill. Ct. Cl. 246, 249-51; Franciscan Medical Center v. State (1988), 44 Ill. Ct. Cl. 431; Treister & Wilcox v. State (1989), 42 Ill. Ct. Cl. 185, 190-91.\nThis claim was commenced within six to nine months following the dates on which the subject services were rendered. IDPA reports that it had received timely DPA-form invoices from a hospital and two other physicians, charging for services to patient McCalla rendered during the same time span as Claimant\u2019s services; and that said hospital and physician invoices had been paid. No invoice by the Claimant can be found. No facts here alleged offer any excuse for the failure of the present Claimants to invoice their service charges to IDPA through administrative channels prior to IDPA Rule 140.20\u2019s prescribed deadline.\nThis Court finds that the Claimant did not respond to the Respondent\u2019s request for admission of fact, nor did the Claimant respond to the Respondent\u2019s motion, or this Court\u2019s order granting 30 days for such a response. Therefore, this Court finds that the facts are as stated in the motion and the verified departmental report submitted by the Respondent, and that the Claimant\u2019s complaint does not state a cause of action.\nIt is therefore hereby ordered and adjudged that Respondent\u2019s motion for summary judgment on the complaint and underlying causes, on the grounds addressed in this opinion, is granted; judgment as to all issues is entered against Claimant Brand, Beck & Hoover Assoc., and its physician-vendors and in favor of Respondent herein; and this claim is dismissed.",
        "type": "majority",
        "author": "Sommer, J."
      }
    ],
    "attorneys": [
      "Gary A. Smiley, for Claimant.",
      "Roland W. Burris, Attorney General (Steven Schmall, Assistant Attorney General, of counsel), for Respondent."
    ],
    "corrections": "",
    "head_matter": "(No. 89-CC-2196\nBrand, Beck & Hoover, Associates, Claimant, v. The State of Illinois, Respondent.\nOpinion filed March 24, 1992.\nGary A. Smiley, for Claimant.\nRoland W. Burris, Attorney General (Steven Schmall, Assistant Attorney General, of counsel), for Respondent."
  },
  "file_name": "0284-01",
  "first_page_order": 392,
  "last_page_order": 396
}